瘦素、肿瘤细胞坏死因子α与COPD患者营养状况及免疫功能关系分析  

The Investigate of Between the Serum levels of Lepin and TNF-α and Malnutrition in Chronic Obstructive Pulmonary Disease

作　　者：李志忠[1] 谭薇[1] 王乐强[1] 郭桂芳[1] 黄宝娥[1] 

机构地区：[1]潍坊医学院附属潍坊市人民医院呼吸科,山东潍坊261041

出　　处：《潍坊医学院学报》2007年第4期314-316,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨瘦素、肿瘤细胞坏死因子α与慢性阻塞性肺病(COPD)患者营养状况及免疫状态的关系。方法采用放射免疫法测定血清瘦素和TNF-α的水平,免疫球蛋白检测采用比浊法,淋巴细胞亚群检测采用FACS 400型流试细胞仪测定,与反映营养状况的各参数、各组进行比较。结果①COPDⅠ组血清瘦素浓度高于及Ⅱ组对照组,Ⅱ组血清瘦素浓度低于对照组;COPDⅠ、Ⅱ组TNF-α高于对照组;COPDⅠ、Ⅱ组TNF-α水平差异亦有显著性(P<0.05)。②COPDⅡ组及对照组血清瘦素浓度与BM I、NW%呈显著正相关(P<0.05),而与身高、体重无相关性;3组血清浓度与TNF-α水平无显著相关性。③COPDⅠ与对照组的免疫功能指标:同对照组比较,COPDⅠ的细胞免疫指标TLC,CD3+,CD4+T,CD8+T明显降低,差异有显著性(P>0.05);而2组体液免疫IgA、IgM、IgG无明显差异(P>0.05);COPDⅠ患者血清瘦素浓度与TLC,CD3+,CD4+T,CD8+T呈正相关。④3组血清TNF-α浓度与BM I、NW%、身高、体重均无显著相关性(P>0.05)。结论①急性期COPD患者血清瘦素浓度高于稳定期组及对照组。②瘦素的调节不受TNF-α系统的控制,也表明TNF-α水平在COPD患者明显增加不依赖于瘦素。③COPDⅠ患者的细胞免疫功能低于正常,瘦素可能参与了T细胞介导的免疫。④血清瘦素浓度水平与营养状态的关系密切。Objective To investigate the effects of serum lepin and tumor factor-α（TNF-α） on nutrition states in patients with chronic obstructive pulmonary disease （COPD）. Methods The serum letpin and TNF-α levels were examined. Body mass index（ BMI） and percent age of normal body weight（ NW% ） were measured. The correlation between leptin and other parameters was analysed. Results The serum leptin and TNF-α levels in acute exacerbation of COPD were significantly higher than those in the stablepatients with COPD and control（ P 〈 0.05 ）. Serum leptin concentration in stable patients with COPD was lower than that in the control,but the TNF-α level was higher than that in the control. Conclusion The elevated leptin and TNF-α level may related to the aggravation and the malnutrition in patients with COPD. Increased TNF-α serum levels in COPD was no correlation with plasma leptin levels and leptin were associated positively with COPD nutritional status.

关 键 词：COPD 瘦素 营养障碍 肿瘤坏死因子 免疫功能 

分 类 号：R563[医药卫生—呼吸系统]